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  • 1. Local Anesthetic Injection
  • 2. Tympanomeatal Flap
  • 3. Elevate Annulus
  • 4. Remove Scutum
  • 5. Middle Ear Assessment
  • 6. Incudostapedial Joint Separation
  • 7. Divide Stapedial Tendon and Posterior Crus
  • 8. Harvest Perichondrium
  • 9. Remove Stapes Footplate
  • 10. Graft Placement
  • 11. Prosthesis Placement
  • 12. Closure